Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
Arch Phys Med Rehabil. 2010 Jun;91(6):857-61. doi: 10.1016/j.apmr.2010.02.012.
To assess the effectiveness of expiratory muscle training on the pulmonary function of spinal cord injured patients.
Randomized controlled trial.
Acute inpatient rehabilitation hospital.
Patients (N=29, 22 men and 7 women) with recent traumatic, motor complete, spinal cord injury (SCI) at or above level T1 consecutively admitted to an SCI rehabilitation service. Subjects were randomized to either resistance training (n=16) or sham training (n=13).
The subjects completed either sham training or expiratory muscle resistive training with maximal expiratory force using a small handheld device, which is a tube with an aperture at the distal end, for 10 repetitions twice a day 5 days a week for a total of 6 weeks.
Pulmonary function tests were measured before and after the training program and included forced vital capacity (FVC); forced expiratory volume in 1 second (FEV1); maximum expiratory pressure (MEP), which is often referred to as forced expiratory pressure; maximum inspiratory pressure (MIP), which is often referred to as negative inspiratory force; inspiratory capacity (IC); expiratory reserve volume (ERV); total lung capacity (TLC); functional residual capacity (FRC); and residual volume (RV).
FVC, FEV1, and ERV improved in both groups. Although exit values of MEP were improved in both groups compared with entry values, this increase was statistically significant only in the resistance training group. No significant improvements occurred in IC, TLC, FRC, or RV from entry to exit. MIP improved in both groups, but this increase was statistically significant only in the resistance training group. There was also a significant between-group difference in MEP exit values (98cmH(2)O for the resistance training group and 59cmH(2)O for the sham training group, t=3.45, P=.002). Multivariate analyses failed to reveal significant effects of treatment for any of the pulmonary function tests.
The resistance training group had significantly greater exit MEP values than the sham training group in univariate analysis only. However, improvements in pulmonary function were noted in both the resistance training and sham training groups. Although multivariate analysis failed to reveal a significant difference between groups, these findings offer some indication that expiratory training may benefit people with SCI.
评估呼气肌训练对脊髓损伤患者肺功能的影响。
随机对照试验。
急性住院康复医院。
连续入住脊髓损伤康复服务的最近因创伤导致的、运动完全性、T1 及以上水平脊髓损伤的患者（N=29，22 名男性和 7 名女性）。受试者随机分为阻力训练组（n=16）或假训练组（n=13）。
受试者每天完成两次，每次 10 次，使用一个小型手持设备进行最大呼气力的呼气肌抗阻训练，该设备是一个在远端有一个开口的管，持续 6 周，每周 5 天。
训练前后进行肺功能测试，包括用力肺活量（FVC）；1 秒用力呼气量（FEV1）；最大呼气压力（MEP），通常称为用力呼气压力；最大吸气压力（MIP），通常称为负吸气力；吸气量（IC）；呼气储备量（ERV）；肺总量（TLC）；功能残气量（FRC）；和残气量（RV）。
两组 FVC、FEV1 和 ERV 均有所改善。尽管两组的 MEP 出口值与入口值相比均有所提高，但仅在阻力训练组中具有统计学意义。IC、TLC、FRC 或 RV 从入口到出口均无明显改善。两组 MIP 均有所改善，但仅在阻力训练组中具有统计学意义。MEP 出口值在两组之间也存在显著差异（阻力训练组为 98cmH(2)O，假训练组为 59cmH(2)O，t=3.45，P=.002）。多变量分析未能显示出治疗对任何肺功能测试的显著影响。
仅在单变量分析中，阻力训练组的出口 MEP 值显著高于假训练组。然而，阻力训练组和假训练组的肺功能均有改善。尽管多变量分析未能显示出组间的显著差异，但这些发现表明呼气训练可能有益于脊髓损伤患者。
